Senior Accreditation Professional

Join Our Caring Community and Put Health First

We are seeking a Senior Accreditation Professional who will work in a team environment on Humana's health plan accreditations, performing complex tasks related to compliance with accreditation standards across multiple operational areas within Humana. Serves as subject matter expert on National Committee for Quality Assurance (NCQA) Health Plan Accreditation and Long-Term Services and Supports (LTSS) requirements, advising stakeholders on compliance, and facilitating NCQA LTSS file universe preparation and LTSS file reviews. Works closely with operational areas to prepare documentation and files for presentation to NCQA. Advises operational leaders and frontline associates in developing functional strategies for compliance with accreditation standards. Self-directed, exercises independent judgement and decision-making on complex issues regarding job duties and related tasks, and works under minimal supervision. Uses independent judgement requiring analysis of variable factors and determining the best course of action.

Required Qualifications

Bachelor's Degree or BSN degree. Minimum three (3) years of experience in NCQA Health Plan Accreditation and Long-Term Services and Supports (LTSS). Prior experience participating in NCQA virtual or onsite surveys. Exceptional analytical and critical thinking skills, including problem solving and proficiency in executing solutions. Exceptional attention to detail. Demonstrated excellent time management skills with proven ability to be flexible, adapt to changing environment, handle multiple tasks and deadlines and manage multiple priorities. Commitment to continuous process improvement. Exceptional verbal and written communication skills. Demonstrated successful relationship building. Experience working with cross-functional business areas.

Preferred Qualifications

Expertise on NCQA accreditation standards, especially related to LTSS. Experience compiling NCQA File Review Universes. Registered Nurse or Behavioral Health professional. Managed care, Medicaid health plan experience. Advanced degree in a healthcare-related field.

Additional Information

Workstyle : This is a remote position with some travel. Travel : Up to 5% travel typically, 3-5 times annually possibly outside of your state of residence for team engagement meetings, onsite audits, and trainings. Workdays & Hours : Monday through Friday; 8 : 00 AM 5 : 00 PM Eastern Standard Time (EST). Must be able to accommodate work schedules and meetings in both Central and Eastern time zones.

WAH Internet Statement : To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria : At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home / Office employees with telephone equipment appropriate to meet the business requirements for their position / job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format : As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline : 01-07-2026

About Us

Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.